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Vegetative and psychological symptoms associated with depressed mood over the first two years after stroke.

Abstract：

INTRODUCTION:In patients with acute physical illness, symptoms used in the diagnosis of major depression such as sleep or appetite disturbance may be nonspecific for depression. This study was undertaken to examine the association of depressed mood with other depressive symptoms to determine which symptoms were most useful in the accurate diagnosis of major depression after stroke. METHODS:Using a structured mental status examination, 142 patients with acute stroke were followed at three, six, twelve, and twenty-four months. RESULTS:The median number of vegetative and psychological symptoms among patients with depressed mood was more than three times the respective rates among nondepressed patients at all time points over two years. Autonomic anxiety, morning depression, subjective anergia, worrying, brooding, loss of interest, hopelessness, and lack of self-confidence were significantly more frequent among depressed patients than nondepressed patients throughout the entire two-year period. Some symptoms such as anxious foreboding and loss of libido, as well as self-depreciation, feelings of guilt, and irritability were no longer significantly more common among depressed compared with nondepressed patients after six months. Standard DSM-IV diagnostic criteria and modified DSM-IV diagnostic criteria which included only specific symptoms of depression (i.e., symptoms which were significantly more frequent among depressed than nondepressed mood patients) yielded similar frequencies of major depression diagnosis. There were only a few patients (i.e., 2% to 3%) with depressive symptoms without a depressed mood (perhaps "masked" depression). CONCLUSIONS:Vegetative and psychological depressive symptoms are significantly more common in depressed patients over the first two years after stroke and DSM-IV criteria do not overdiagnose major depression even in this population with chronic physical illness. The symptoms which characterize major depression appear to change between the subacute and chronic post-stroke periods.

journal_name

Int J Psychiatry Med

journal_title

International journal of psychiatry in medicine

authors

Paradiso S,Ohkubo T,Robinson RG

doi

10.2190/BWJA-KQP3-7VUY-D06T

subject

Has Abstract

pub_date

1997-01-01 00:00:00

pages

137-57

issue

eissn

0091-2174

issn

1541-3527

journal_volume

pub_type

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Vegetative and psychological symptoms associated with depressed mood over the first two years after stroke.